Primary gastric lymphoma: clinicopathologic study of gastric lyphoma cases and the treatment option of choice

Lymphoma may involve the gastrointestinal tract either primarily or as a manifestation of extensively disseminated systemic disease. Stomach being the most frequent site of primary gastroin-testinal lyphoma, followed by the small bowel and colon respectively [1 and 2 and 3]. For diagnosis of pi-mary small intestinal lymphoma [PSIL], one most satisfies the criteria specified by Dawson and co-workers.[5] Gastric lymphoma is a common presentation of non-Hodgkin's lymphoma. Controversy reigns about many aspects of its classification and management, especially regarding roles for surgical resection. The aim of this study is evaluation of 5 years survival and methods of treatment of primary gastric lymphoma in a group of Iranian patients. The authors review the clinical features, staging, pathology, prognosis, and management of 30 patients with an emphasis on the role of chemotherapy, surgical resection and radiotherapy of 71 gastrointestinal lymphoma cases. A total of 30 patients [19 male and 11 female] with a mean age of 51 years and a range of 34 - 68 years were included in the study. The frequency of primary gastric lymphoma in our series was 42% of the total of primary gastrointestinal lymphoma. The overall survival rate was 47.8% at 5 years. Stag-ing usually was completed using noninvasive techniques. Patients with stage I or II disease were treated with Surgery [gastric resection] and chemotherapy showed improved Free Disease Survival [FDS] of 67% at 5 years. The five-year survival for stage I, II, III and IV patients were 87%, 61%, 25%, and 11% respectively, and the five-year survival for low grade and high grade were 91% and 56%, respec-tively. Stage III or IV and inoperable primary gastric lymphoma were treated with chemotherapy and radiotherapy showed improved Free Disease Survival [FDS] of 67% at five years. The five-year sur-vival for stage I, II, III, IV were 87%, 61%, 25% and 11% respectively, and the five year survival for low grade and high grade were 91% and 56% respectively. Early stage disease and high-grade Lymphoma have a better prognosis and patients who have complete surgical removal of primary tumor and chemotherapy

Autologous marrow transplantation in the treatment of MOPP and ABVD resistant Hodgkins disease

Six patients with disseminated Hodgkin's disease resistant to MOPP [mechlorethamine, vincristine, procarbazine and prednisolone], and ABVD [adriamycin, bleomycin, vinblastine and dacarbazine] chemotherapy were treated with high-dose chemotherapy and autologous marrow transplantation. The patients first underwent marrow aspiration and storage for subsequent autologous bone marrow transplantation [ABMT]. Three patients remain alive in unmaintained complete remission [CR] at 18,17, and 15 months after transplant. In the other three patients, reasons for failure included relapse in two patients after 7 and 8 months, and death after 6 months due to pulmonary infection [pneumonia]. These results demonstrate that some patients with MOPP, ABVD and other salvage chemotherapy [SC]-resistant Hodgkin's disease can obtain prolonged complete remission following intensive chemotherapy and autologous marrow transplantation

Salvage chemotherapy with cyclophosphamide, doxorubicin, and cisplatin [CAP] in advanced breast cancer

Twenty-one patients with advanced breast cancer[7 premenopausal and 14 postmenopausal women] were treated with a combination of cyclophosphamide, doxorubicin, and cisplatin [CAP]. The median age of the patients was 43 years [range 36-61]. This therapy was repeated every 3 weeks. Nine patients [group 1] received CAP as primary therapy for metastatic breast cancer, and twelve patients [group 2] received CAP as a second-line therapeutic agent. Of the 12 [57%] patients who responded, six [29%] had complete response [CR]. The median disease-free survival [DFS] was 8 months. The response rate was highest for metastases in the pleura [83%] and lymph nodes [81%], followed by skin [64%], liver and breast [55%]. The overall response rate was higher in previously untreated patients than in those previously treated [89% versus 33%, p<0.01]. Complete response rates of 44% and 17%, and median DFS of 10.5 and 3 months respectively, were observed in the two groups of patients. The therapy was well tolerated, myelosuppression being the dose limiting toxicity. The most frequent nonhematological toxicities were nausea, vomiting [100%], mucositis and stomatitis [38%], but these were rarely severe. Total alopecia occurred in only two patients. There were no toxic deaths or cardiotoxicity. Severe anemia occurred more frequently in group 2 patients. The present study suggests a role for CAP combination chemotherapy in the management of advanced breast cancer

Effectiveness of chemotherapy in 54 cases of advanced gastric cancer in Isfahan

To determine the effectiveness of chemotherapy in the treatment of gastric cancer, a sample of 54 patients suffering from advanced adenocarcinomas were studied. The results of the study showed that the disease is more prevalent in the age group of 56-60 years. The three major signs of this kind of cancer were almost equally present among both sexes in our patients. After chemotherapy, 74% of the patients survived up to one year and 50% survived up to two years or more following treatment. Chemotherapy increased the survival rate of the patients but our results were less successful compared to that of other institutions. This probably is due to delayed referral of patients to the physician. It is suggested that those patients in age groups 56-60 showing the slightest signs of gastric cancer be examined by a physician and it is hoped that early detection of the disease will increase the survival rate of the patients

Small intestinal lymphoma and alpha heavy chain disease reviewing 15 advanced cases and commenting on the results of therapy

The IPSID in its severe cases invades the lymph nodes, mesenterium, and abdominal viscera resembling NNL Low grade .Diarrhea and malabsorption were present in all of the 15 patients under study. Moreover, 14 patients were suffering from obvious weight loss more than 10 peresented mild anemia together with the increased IgA in the serum, clubbing was also present in two thirds of the patients. Chemotherapy alone or combined with radiotherapy caused rapid regression of the disease. The patients had comparatively long survival, see table 4